NBCOT Exam Prep Contents - Occupational Therapy...
Transcript of NBCOT Exam Prep Contents - Occupational Therapy...
NBCOT Exam Prep
Contents NBCOTPracticeQuestions P.26WeekStudySchedule P.113NBCOTFAQs P.121NBCOTTipsandTestingStrategies P.125
For updates to this guide and more NBCOT Exam Prep material, visit: occupational-therapy-assistant.org/NBCOT
COTA Review ThissectionisthecompleteCOTANBCOTreviewconsistingof
552OTtermsandquestions.
Theleftcolumncontainstheterm/questionandtherightcolumncontainsthedefinition/answer.Foldthepageinhalfdownthemiddleorcovertheanswers/definitionsasyou
study.
Reviewthismaterialfor2weekstakingnoteoftopicsyoufeelweakin.Thenfilloutyourstudyscheduleinthenextsection
focusingonthoseweakareas.
For updates to this guide and more NBCOT Exam Prep material, visit: occupational-therapy-assistant.org/NBCOT
2 1/2 years? -Unbuttons large buttons
-Assists in putting on socks
A 15 year-old with arthrogryposis undergoes
serial
casting of the right wrist with weekly cast
changes. After four weeks upon cast removal the
therapist notes both a small open area 1/4cm. by
1/4cm. and a red rash over the ulnar styloid. The
therapist's best response is to?
-refer the individual to the physician to
dx the
Finding
According to Mosey what are the major
types of
activity groups?
-Evaluation group
-Thematic group
-Topical group
-Task-oriented group
-Developmental group
-Instrumental group
According to the OT code of ethics what
is
defined as autonomy?
Respect patient rights including
confidentiality.
According to the OT code of ethics what
is
defined as beneficence?
Concern for the safety and well-being of
the
recipients of OT services.
According to the OT code of ethics what
is
defined as duty?
Maintain credentials and continually
learn craft
According to the OT code of ethics what
is
defined as fidelity?
Treat colleagues and other professionals
with
respect fairness and integrity.
According to the OT code of ethics what
is
defined as nonmaleficence?
Ensure recipient's safety and do no
harm.
According to the OT code of ethics what
is
defined as procedural justice?
Comply with laws
According to the OT code of ethics what
is
defined as veracity?
Providing accurate information when
representing
the profession (don't lie)
After swallowing a pureed substance
you notice
the individual has a wet gurgling voice.
What
might this indicate?
Possible aspiration. A videoflouroscopy
is often
times needed to determine is this is the
case.
At what age is a child I in toileting? 4 to 5 years
At what Ranchos level are patients
aware of the
month and year?
Level VI
At what Ranchos level can an individual
perform
self care with minimal assist?
Level VI
At what Ranchos level can a patient
follow a
schedule but get confused by changes
in the
routine?
Level VI
At what Ranchos level can a patient pay
attention
for up to 30 minutes?
Level VI
At what Ranchos level is an individual
ready for
vocational and/or driving training?
Level VIII
At what Ranchos level is a patient
independent in
self care but continues to need
supervision
because of safety awareness and
judgment?
Level VII
At what Ranchos Los Amigos level do
individuals
begin to begin to remember events
before the
accident better than their daily routine?
Level V. At this level patients also
confabulate in
order to fill in gaps in memory
At what Ranchos Los Amigos level do
individuals
begin to engage in simple routine
activities such
as self feeding and dressing?
Level IV
At what Ranchos Los Amigos level do
individuals
begin to follow simple directions like
"Squeeze my
hand?
" or "Look at me"?,
Level III
At what Ranchos Los Amigos level do
individuals
begin to recognize family and friends?
Level III
At what SCI level can a person use a
universal
cuff?
C6
Brachial Plexus injury?
- Types are Traumautic and Obstetric
- Traumatic (Road Traffic Injuries/falling a
motorcycle)
- signs
* a weakness in the arm
* diminished reflexes
* corresponding sensory deficits
By what age does an infant sit erect and
unsupported for several minutes?
By 8 to 9 months an infant can sit erect
and
unsupported.
Can OT Assistants be activities directors
in skilled
nursing facilities?
Yes and they can also supervise OT aids
Can someone with receptive aphasia
participate in
sensory testing?
Individuals with this disorder cannot
comprehend
spoken or written words or symbols.
Individuals
cannot understand verbal directions or
respond to
sensory stimuli.
A five year-old with moderate spastic cerebral
palsy works on ambulation with a walker in
physical therapy. The OT evaluation reveals
problems in lower extremity dressing transitional
skills self-feeding and grasp and release skills. To
facilitate the child's goal of ambulation the
occupational therapist elects to work on:
-donning and doffing shoes and socks in
bench
sitting with one leg externally rotated and
placed
on the opposite knee: encourages dynamic
trunk
balance LE external rotation and dissociation
Give examples of IADLs?
-Care of pets
-Care of others
-Child rearing
-Communication devices
-Financial management
-Meal preparation and cleanup
How are cold packs most effectively
placed?
In an elevated position
How are eating disorders treated?
Activities to promote a reality based
body image
education and management of nutrition
and
activities to improve communication
skills and
self-expression
How are oppositional defiant disorder
and conduct
disorder treated?
OT intervention focuses on development
and
improvement of self-esteem/self-
efficacy. A focus
is placed on developing the skills
needed for
ADL's social leisure and school behaviors
How does a patient with a recent total
knee
replacement sleep?
Patient should on unoperated
unaffected side
How does a person with hemiplegia doff
a
pullover shirt?
-First gather up shirt from top back with
unafected
hand
-Lean forward duck head and pull gathered back
fabric over head
-Remove first from normal arm then affected
arm
How does a person with hemiplegia
donn a
button-up shirt?
-Put shirt on lap with inside up and collar towards
the chest (upside down)
-Position sleeve opening on affected side
-With normal hand place involved hand into
sleeve
-Put normal arm into other sleeve and bring arm
out to 180 degrees of abduction
-With normal hand pull shirt over head and it will
be positioned correctly in order to button
How does a person with hemiplegia
donn a
pullover shirt?
-Lay shirt on lap
-With normal hand roll up bottom edge of shirt
until you reach sleeve of affected arm
-Position sleeve opening as large as possible and
use normal hand to place affected hand into sleeve
opening
-Pull shirt past elbow and insert normal arm into
sleeve
-Complete putting on shirt
How do you measure a wheelchair
armrest?
From the buttocks to the bent elbow add
one inch
How do you measure footrest height?
-From the bottom of the heel to the
popliteal fossa
when individual is in 90 degrees of knee
flexion
-Subtract two inches for floor clearance
How do you measure seat depth? From the buttocks to the popliteal fossa
(behind
the knee) subtract one to two inches
How do you treat anesthesia?-Anesthesia is complete loss off
sensation
-Precautionary techniques
-Compensatory techniques
How do you treat spinal cord patients
with
anesthesia?
-Pressure relief equipment
-Changing position throughout the day
using timer
-Inspect skin with mirrors
How is adhesive capsulitis (frozen
shoulder)
treated?
-Pain management (heat cryotherapy TENS
myofascial release)
-PROM stretching
-Strengthening exercises/activities
What are the weight-bearing restrictions for hip
arthroplasty?,
-No weight bearing
-Toe touch (10% on the affected and 90% on the
unaffected)
-Partial weight bearing (50%)
-Weight bearing as tolerated
-Full weight bearing
How is a wheelchair seat measured?-Across the widest point of the hips of
thighs
-Add half an inch to one inch on each
side
How is desensitization done?
-Grade stimulus from soft to hard to rough
-Grade force of application from touch to:
rub->tap->prolonged
Ex: -rub: pet cat fingerpaint sandcastles
-tap: juggle cotton balls ping pong balls or tennis
balls
-prolonged: flour rice beans macaroni
-Compensation- Ex: padding objects
How is Rett's syndrome treated?
Treatment may involve adaptations to
maintain the
integrity of the skin such as dynamic
elbow splints
that inhibit a hand to mouth pattern by
limiting full
elbow flexion
How is sensory retraining done?
-Sensory Retraining- learn the meaning of new
sensation
1. vigorous generalized cutaneous stimulation
(Ex: rub affected area briskly with terrycloth)
2. cognitive cueing (Ex: OT & pt. discuss stimuli)
3. feedback (Ex: visual feedback)
-Compensatory Techniques: visual thermometers
How is the Glasgow Coma Scale
interpreted?
3-8: Severe injury (In a coma)
9-12: Moderate injury
13-15: Mild or no injury
How is ulnar nerve palsy splinted?
Splint to prevent MCP hyperextension of the
ring
and small finger
How is wheelchair back height
measured?
-From the bottom of the buttocks to the top of the
shoulder
-Subtract four to three inches depending on trunk
control and UE strength
-Head rest may be required if no trunk control
Present
How much should a ramp be graded? Maximum slope of 1 foot of ramp per
every inch
of rise in height
How should sensation testing be
conducted in a
peripheral nerve injury?
-Tested distal to proximal
-Vision occluded
-Test uninvolved side first
How should sensation testing be
conducted in a
spinal cord injury?
-Tested proximal to distal
-Vision occluded
-Test uninvolved side first
How tall should a door threshold be for
wheelchair
accessibility?
1/2" and should be bevelled-- should be
removed
if possible.
If active ROM is less that passive ROM
what does
that indicate?
Muscle weakness
In a cooperative level what is the role of
the
therapist?
-The therapist intervenes to promote
cohesiveness
and group problem-solving
In a mature group level what is the role
of the
therapist?
To act as a member of the group
In an activity group of an inpatient unit
how
should activities be done?
On an inpatient unit activities should be
structred
easily completed in one session and
provide a
concrete result to reinforce reality
In an acute care psychiatric setting
which group
treatment is the most appropriate for
individuals
with disorganized psychosis?
Directive group treatment: a highly
structured
approach used in acute care for
minimally
functional individuals.
An individual diagnosed with bipolar
disorder of
the manic type begins an OT activity
group. For
the first experience in the group setting
the
therapist should suggest:
A structured project w/ easily-completed
steps to
increase self-esteem (i.e.: making a
leather wrist
band w/client's name)
An individual functions at level five
according to
the Allen Cognitive Test. The highest
level task
that the individual can perform is to:
-Carry out a task with three familiar
steps and one
new step
An individual needs step-by-step
instruction to
perform self care. What Ranchos level
are they at?
Level V
An individual with schizophrenia continues to
experience periods of hallucinations after two
changes in medications. During the OT project
group the individual begins to actively
hallucinate. The COTA should:
-Redirect attention back to the project
and
reinforce all misinterpretations of
enviromental
noises and events use a calm tone focus
on reality
In infant development which comes
first:
bilaterality or unilaterality?
__________ precedes unilaterality in infant
development
In mental health planning for discharge
involves
evaluating what?
Occupational performance
integration in the neonatal period?
-Tactile proprioceptive and vestibular
input
needed for body scheme
-Vestibular defines arousal level
-Visual system develops as infant
responds to
faces and items placed 10" from face
integration in the six to twelve month
period?
-Fine motor and motor planning develop
due to
refinement of tactile and proprioceptive
senses
-Midline skills and crossing midline
-Primitive self-feeding
Is a person who is considered a risk to
themselves
or others eligible for ADA protection?
No. The person must be able to perform
the job
task safely without risk of harming
patients.
Is a shower chair considered a DME?
Adaptive equipment is not covered
under
Medicare as a DME. Items not included
are
shower chairs reachers hand-held
showers.
Of Broca's and Wernicke's which is
expressive
and which is receptive aphasia?
-Broca's: Expressive Aphasia
-Wernicke's: Receptive Aphasia
Several adolescents with behavior problems
attend
an after-school program in a mental health
outpatient program. They work at an
egocentric-cooperative level in a group dealing
with issues related to peer pressure. The
participants would be most likely to:
Focus on the group tasks rather than the
feelings of
the participants.
Should you pass a Level II fieldwork
student if
they are functioning below the minimal
entry
level?
Students functioning below entry level
should be
failed.
-Sometimes requires joint replacement
surgery
What is ankylosis?
-Fixation or fusion of a joint often in an
abnormal
position
-Usually results from destruction of
articular
cartilage as in RA
Ten members of the community resource group
are not working well together and show
decreased
levels of trust. The COTA's goal is to enhance the
level of cohesiveness in the group. The best
choice
for the COTA is to:
Verbally reinforce the goals and
purposes of the
group.
-Used during functional activities
What is a cock up splint?
This splint supports the user's wrist in
10° to 20°
of extension to prevent contracture but
allows
digits to function such as in a case
involving a
flaccid wrist
What ankylosing spondylitis?
-A chronic inflammatory disease of ideopathic
origin
-First affects the spine in adjacent structures and
commonly progresses to eventual fusion
(ankylosis) of involved joints
What are cluster A personality
disorders?
Paranoid schizoid schizotpal (odd/peculiar
behavior)
What are cluster B personality
disorders?
Antisocial borderline histrionic
narcissistic
(dramatic/implusive)
What are cluster C personality
disorders?
Avoidant dependent obsessive
compulsive
(anxiety/fear)
What are common cardiac precautions?
-Don't push and pull with UEs
-Don't lift weights
-Perform transfers using mostly LE
strength
-Don't lean below level of the heart
-Don't raise both arms at same time
What are components of a
biomechanical activity
analysis?
-What is the activity?
-Positioning
-Precautions
-Steps
-Repetition
-ROM required
-Minimal muscle strength required
-Type of contraction
-Appropriate for short term or long term goal
What are corrective splints?
Corrective splints are static splints used to:
- maintain improvement obtained through therapy
- correct soft tissue contractures
What are games?- 7-12 years
-Rules competition
-Friends become important for
validation
What are hip precautions for
posterolateral hip
arthroplasty?
-No hip flexion more than 90
-No hip internal rotation
-No hip adduction (No crossing legs or
feet)
What are IADLs?
Activities that are oriented toward interacting
w/the environment and that are generally optional
What are intention tremors?
Occurs during voluntary movement. Intensified at
the termination of the movement and often
associated with MS.
What are intervention strategies for
aphasia?
-Decrease external auditory stimuli
-Give individual increase response time
-Use concise sentences
-Use visual cues and gestures
What are intervention strategies for
body neglect?
Provide bilateral activities guide the
affected side
through the activity and increase
sensory
stimulation to the affected side
What are intervention strategies for
ideational
apraxia?
Provide step-by-step instructions and
hand over
hand guiding
What are intervention strategies for
perseveration?
Bring the perseveration to a conscious
level and
train the person to inhibit the behavior
What are intervention strategies for
sequencing
and organization deficits?
-Use external cues such as written
directions and
daily planners
-Use graded tasks that increase in
complexity in
terms of number of steps required
What are intervention strategies for
spatial
neglect?
-Provide graded scanning activities
-Use external cues such as colored
markers and
written directions
What are orthosis?
Orthosis are permanent devices that replace or
substitute for loss of muscle function
What are precautions of neuroleptic
medications?
Power tools and sharp instruments
should be
avoided and sun exposure should be
limited.
What are Process Skills (Practice
Framework)?
-energy
-knowledge
-temporal organization (time)
-organizing space & objects
What are protective splints?
Protective splints are static splints used to:
- immobilize a joint or limb following trauma are
fracture and some post-surgical conditions
What are resting tremors?
Occurs at rest and subsides when voluntary
movement is attempted.
Seen in Parkinson's disease.
What are seral static splints?
Serial static splints hold the tissue in
end range
until it adaps to its new length to
increase ROM
and maintain improvement obtained
What are SOAP notes?
-Subjective
-Objective
-Assessment
-Plan
What are static progressive splints?
Static progressive splints apply low-load
prolonged stress at the end range to soft tissue
through static positioning to increase ROM and
correct contractures
What are supportive splints?
Supportive splints are static splints used to:
- relieve pain
- position and maintain join alignment
- prevent adaptive shortening of soft tissues
What are symptoms of Rett's syndrome?
Characterized by repetitive movements of licking
biting and slapping of one's hands
What are the 4 basic steps of program
development?
-Needs assessment
-Program planning
-Program implementation
-Program evaluation
What are the behavioral characteristics
of damage
to the hypothalamus?
The hypothalamus regulates bodily functions
such
as thirst hunger body temperature emotion and
circadian rhythm. Damage can result in:
-Uncontrolled eating or drinking
-Mood alteration
-Sleep disorder
What are the behavioral characteristics
of damage
to the limbic system?
Plays integral part in the expression of
emotion.
Damage can affect:
-Emotional behavior
What are the behavioral characteristics
of damage
to the reticular formation?
The reticular formation is in the core of the
brainstem. Contains fibers en route to and
from the
brain. Damage to the reticular activitating
system
results in:
-Sleeping longer periods at a time
What are the behavioral charcteristics of
damage
to the cerebellum?
The cerebellum regulates balance and
posture.
Damage can cause problems with:
-Fine motor control
-Coordination
What are the behavioral charcteristics of
damage
to the thalamus?
-Communications relay station for all
sensory
information
-Damage can alter states of arousal
memory
defect speech deficits apathy and
disorientation
What are the brain behavioral
characteristics of
damage to the frontal lobe?
The frontal lobes order information and sort out
stimuli. Damage to the frontal lobe affects:
-Concentration and attention
-Abstract thinking
-Concept formation
-Foresight
-Problem solving
-Broca's Aphasia
What are the brain behavioral
characteristics of
damage to the parietal lobe?
Contains reception areas for touch and body
position. Damage includes deficits in:
-Sense of touch proproception temperature
and
pain
-Disorganization
-Distorted self perception
What are the brain behavioral
characteristics of
occipital lobe damage?
Occipital lobe contains visual reception
areas.
Damage can result in:
-Anopsia/quadrantanopsia
-Object recognition and visual scanning
deficits
What are the brain behavioral
characteristics of
temporal lobe damage?
Temporal lobes contain auditory reception and
visual processing areas. Damage to temporal lobes
may affect:
-Sound discrimination
-Voice Recognition
-Language and Comprehension
-Auditory and visual memory storage
-Wernicke's Aphasia
What are the characteristics of bipolar
disorder
type I?
-Full manic episodes
-Promiscuity
What are the characteristics of bipolar
disorder
type II?
-Hypomanic
-Depressed
-Symptoms not severe
What are the characteristics of paranoid
personality disorder?
-Feelings of being threatened or
persecuted
-Indiv is withdrawn suspicious
-Have dillusions/hallucinations
What are the charateristics of
individuals with
oppositional defiant disorder?
Impulse contral attention span and
short-term
Memory
What are the classic signs and
symptoms of
osteoarthritis?
-Diffused pain
-In cases of advanced OA pain may be severe
enough to wake individual
-Synovial inflammation
-Capsular distention places pressure on nerve
endings
-Muscle spasms around affected joint
-Pain and tenderness in peri-articular structures
-Mild to mod joint stiffness
What are the clinical signs of a high-
level median
nerve injury?
-Loss of wrist flexion
-Loss of thumb flexion palmar abduction
and
opposition
-Loss of active pronation
What are the clinical signs of a high-
level ulnar
nerve lesion?
-Hyperextension of the MCP ring and
small finger
(Bishop's hand)
-Absent hypothenar and interossei
-Wrist flexion abnormal
What are the clinical signs of a high
radial nerve
injury?
-Wrist drop
-Thumb in palmar abduction
What are the clinical signs of a low
(distal) radial
nerve injury?
-Occurs at or below level of wrist
-Incomplete extension of fingers and
thumb MCP
-PIP and DIP can be extended
What are the clinical signs of a low-level
median
nerve injury?
-Flattened thenar eminence
-Loss of thumb flexion palmar abduction
and
Opposition
What are the clinical signs of a low level
(posterior
interosseus/deep branch of radial
nerve)injury?
-Wrist extension is normal
-Sensation is normal
-Posterior interosseus branch of radial
nerve
innervates only muscles not sensory
-Loss of finger and thumb extension
What are the clinical signs of a low-level
ulnar
nerve lesion?
-Clawing of the MCP ring and small
finger
(Bishop's hand)
-Flexion of the PIP and DIP of the small
finger
-Wrist flexion normal
What are the common splinting
precautions?
-Preexisting skin problems
-Bony prominences
-Friction
-Pressure spots
What are the components of a goal?
-Person
-Behavior
-Condition
-Criterion
-Function
What are the components of motor
development?
-Crossing midline
-Laterality
-Bilateral integration
-Fine coordination and dexterity
-Visual-motor integration
-Oral-motor control
What are the deformaties related to
rheumatoid
arthritis?
-Swan neck
-Boutonniere Deformity
-Zig-Zag Deformity
What are the different types of cerebral
palsy?
-Spastic CP
-Athetoid CP
-Flaccid CP
-Ataxic CP
What are the dressing skill milestones at
1 year?
-Cooperates with dressing
-Pulls off shoes and socks
What are the dressing skill milestones at
2 year?
-Helps pull down pants
What are the dressing skill milestones at
2 ½
What are the dressing skill milestones at
3 1/2
years?
-Works snaps or hooks in front
What are the dressing skill milestones at
3 years?
-Puts on shirt w/ Min A
-Zips and unzips
-Pulls down pants I
-Buttons large buttons
What are the dressing skill milestones at
4 year?
-Removes pullover I
-Laces shoes
-Identifies front and back
What are the dressing skill milestones at
5 years?
-Ties and unties knots
-Dresses I
What are the four types of mental health
service
delivery?
-Traditional
-Partnership
-Supportive
-Seperatist
What are the general considerations of
splinting?
- Comfort
- Function
- Cosmesis
- Patient acceptance and compliance
- Patient education
- Tratment plan integration
What are the hip precautions for an
anterolateral
hip arthroplasty?
-No hip extension
-No hip external rotation
-No hip adduction (No crossing legs or
feet)
What are the main goals of work
hardening?
To return the individual to work. Focus
on pain
management and proper body
mechanics is key.
What are the methods used to treat
hypersensitivity such as burns
amputations PNS
injuries etc?
-Desensitization
-Compensation (Such as testing hot
water with
other hand)
What are the methods used to treat
hyposensitivity?
-Sensory retraining
-Compensation (Such as testing hot
water with the
other hand padding objects)
What are the muscles of the rotator
cuff?
Supraspinatus
Infraspinatus
Subscapularis
Teres Minor
What are the normal ROM limits for
pronation and
supination?
0-80/90 degrees
What are the normal ROM limits of
cervical
flexion extension and lateral flexion?
0-45 degrees
What are the normal ROM limits of
cervical
rotation?
0-60 degrees
What are the normal ROM limits of
elbow
extension?
0 degrees
What are the normal ROM limits of
elbow
flexion?
0-140 degrees
What are the normal ROM limits of
horizontal
abduction?
0-40 degrees
What are the normal ROM limits of
horizontal
adduction?
0-130 degrees
What are the normal ROM limits of
lateral flexion
of the spine?
0-40 degrees
What are the normal ROM limits of
rotation of the
spine?
0-45 degrees
What are the normal ROM limits of
shoulder
abduction?
0-170 degrees
What are the normal ROM limits of
shoulder
adduction?
0 degrees
What are the normal ROM limits of
shoulder
extension?
0-60 degrees
What are the normal ROM limits of
shoulder
external rotation?
0-90 degrees in shd abduction
0-80 degrees in shd adduction
What are the normal ROM limits of
shoulder
flexion?
0-170 degrees
What are the normal ROM limits of
shoulder
internal rotation?
0-70 degrees in shd abduction
0-60 degrees in shd adduction
What are the normal ROM limits of
thoracic and
lumbar spine extension?
0-30 degrees
What are the normal ROM limits of
thoracic and
lumbar spine flexion?
0-80 degrees
What are the objectives of dynamics
splints?
- prevent progressive deforming
changes as a
result of muscle imbalance
- substitute for or assist lost or
weakened muscles
- increase ROM
- minimize formation of adhesions
What are the objectives of static
splinting?
The main purporse of splinting is to help the
individual perfom ADLs through:
- positioning and maintaining alignment
- protecting or supporting or immobilizing
- inhibiting tone by positioning the extremity
in a
reflex inhibiting position
What are the precautions for total knee
replacements?
-No internal or external rotation of the
knee (via
twisting the foot)
-No forced flexion
-Prevent flexion contractures by
extending
What are the psychiatric symptoms of
head
trauma?
-Psychosis
-Disturbances of mood
-Personality changes
-Agitated/withdrawn
What are the signs of a Deep Venous
Thrombosis
(DVT)?-Edema
-Increased venous pattern
-Pain and tendernous
-Low-grade idiopathic fever
What are the signs of a pulmonary
embolism?
-Sudden shortness of breath (SOB)
-Hyperventilation
-Cardiac Arrhythmias
What are the stages of group
development?
1) Origin phase
2) Orientation phase
3 )Intermediate phase
4) Conflict phase
5) Cohesion phase
6) Maturation phase
7) Termination phase
What are the steps in an activity
analysis?
1) Break down componens of activity
2) Determine performance components
3) Assess therapeutic value of activity
What are the steps in determining
reasonable
accomodation?
-Job analysis
-Disability-related limitations
-Identify potential accomodations
-Select and implement
What are the styles of group leadership? -Directive
-Facilitative
-Advisory
What are the subtests of the Glasgow
Coma Scale?
-Eye opening (E)
-Best Motor Response (M)
-Best Verbal Response (V)
-Minimum score of 1 in each subtest = 3
-Maximum score is 15
E+M+V=3-15
What are the subtypes of schizophrenia?
-Paranoid type
-Disorganized type
-Catatonic type
-Undifferentiated type
-Residual type
What are the treatment goals for
osteoarthritis?
-Address patient's pain and inflammation
-Splinting
-Increase functional (not optimal) ROM
-Increase functional mobility and
independence in
ADLs
-Education on joint protection techniques
What are the two types of chorea? -Tardive dyskinesia
-Huntington's disease
What are the types of approaches used
in program
evaluation?
-Continuous quality improvement (CQI):
limitations and problems used to improve quality
-Utilization review: reviews use of resources in
facility
-Peer review
-Professional review organization
-Risk management
What are the warning signs of
inflammatory
arthritis?
-Swelling in one or more joints
-Early AM stiffness lasting more than one hour
-Recurring pain or tenderness in any joint
-Inability to move the joint
-Redness and warmth in the joint
-Unexplained weight loss fever or weakness
What behavior would a child with poor
modulation of tactile input display?
Children with autism often are
unpredictable both
craving and avoiding sensory stimuli at
various
times.
What can an individual accomplish at
Allen's
Cognitive Level 1?
Automatic actions
What can an individual accomplish at
Allen's
Cognitive Level 2?
Aware of large objects an can
accomplish very
simpl tasks
What can an individual accomplish at
Allen's
Cognitive Level 3?
-Patients use hands for simple repetitive
tasks
-Unlkely to produce consistent end
product
What can an individual accomplish at
Allen's
Cognitive Level 4?
-Patients are able to copy demonstrated
directions
(ie - visual and verbal cues) presented one
step at a
time
-Individuals can copy a sample plan to follow
Directions
What can an individual accomplish at
Allen's
Cognitive Level 5?
-Patients perform tasks involving three
familiar
steps and one new one
-New learning occurs at this level
What can an individual accomplish at
Allen's
Cognitive Level 6?
-Patients can anticipate errors and plan
ways to
avoid them
-Can follow written directions
-Operate at normal capacity
What can someone with an IQ range
below 25
accomplish? What classification of MR is
this?
Profound Retardation:
-Need caregiver assistance for basic
survival skills
-Often have neuromuscular orthopedic
or
behavioral deficits
What can someone with an IQ range of
25-39
accomplish? What classification of MR is
this?
Severe Retardation:
-Learns to communicate through
gestures and
some words
-Trained in basic health habits
-Require supervised living or group
home
What can someone with an IQ range of
40-54
accomplish? What classification of MR is
this?
Moderate MR: 40-54:
-Can communicate & get vocational training
-Can only do unskilled or semi-skilled work in
sheltered workshops
-Can handle routine daily functions
-Can only learn up to a second-grade level
-Require supervised living or group home
What can someone with an IQ range of
55-69
accomplish? What classification of MR is
this?
Mild retardation:
-Social/verbal skills to 6th grade level
-Able to take care of self
What characterizes a Boutonniere's
deformity?
-PIP flexion
-DIP hyperextension
(Memory hint-Push your finger into the table in
order to replicate this)
What characterizes a Swan-Neck
deformity?
-MCP flexion contractures
-PIP hyperextension
-DIP flexon
What characterizes athetoid CP with
spasticity?
-Tone fluctuates from normal to high
-Proximal stability
-Proximal spasticity
-Distal athetosis (slow writhing
continuous and
involuntary mvmt of the extremities)
What characterizes athetoid CP with
tonic spasms?
-Unpredictable tone
-Changes from low to very high
-All flexion or all extension
What characterizes choreoathetosis CP?
-Constant fluctuation from low to high
tone
-No cocontraction
-Jerky involuntary movement
-More proximal than distal
What characterizes dementia?-Patient is cooperative but frustrated
-Onset is insidious
-Cognition is prominently impaired
-Symptoms worsen as day progresses
What characterizes flaccid CP?-Markedly low tone
-Seen at birth or toddler
-Later classified as spastic athetoid or
ataxic
What characterizes mild spastic CP? -Has normal tone at rest
-Tone increases with effort and
movement
What characterizes moderate spastic
CP?
-Near normal tone at rest
-Tone increases with excitement
movement
emotion and speech
-More distal than proximal
What characterizes pure athetoid CP? -Tone fluctuates from low to normal
-No or little spasticity
-No coactivation
What characterizes severe spastic CP?
Characterized by:
-Severe increased tone
-Flexion and extension cocontraction
-High tone always
-More proximal than distal
What does a manual muscle test of (0)
indicate?
Zero (Z): No muscle contraction can be
seen or
Felt
What does a manual muscle test of (1)
indicate?
Trace (T): Contraction can be felt or seen
underneath the skin but there is no
motion
What does a manual muscle test of (2+)
indicate?
Poor Plus (P+):
-Part moves through incomplete range of
motion
(less than 50%) against gravity
-OR through complete range of motion with
gravity decreased against slight resistance
What does a manual muscle test of (2)
indicate?
Poor (P): Part moves through complete
range of
motion with gravity eliminated
What does a manual muscle test of (2-)
indicate?
Poor Minus (P-): Individual is only able to
move
joint through incomplete range of
motion with
gravity eliminated
What does a manual muscle test of (3+)
indicate?
Fair plus (F+): Part moves through
complete range
of motion against gravity and slight
resistance
What does a manual muscle test of (3-)
indicate?
Fair minus (F-): Part moves through
incomplete
range of motion (more than 50%) against
gravity
What does a manual muscle test of (3)
indicate?
Fair (F): Part moves through complete
range of
motion against gravity
What does a manual muscle test of (4)
indicate?
Good (G): Part moves through complete
range of
motion against gravity and moderate
resistance
What does a manual muscle test of (5)
indicate?
Normal (N): Part moves through
complete range
of motion against gravity and full
resistance
What does Medicare Part A cover?
-Pays for hospital inpatient SNF home
health and
hospice care
-Requires annual deductible fees
-Automatically provided by all cover in
Social
Security system that meet criteria
What does Title 4 of the ADA address? Telecommunications for hearing and
speech
Impaired
What domains are included in the
Practice
Framework?
1) Performance Areas
2) Performance Skills
3) Performance Patterns
4) Context
5) Activty demands
6) Client Factors
What elbow exercises are needed for an
individual
with spinal cord injury?
-Engage triceps in activity to prevent
flexion
contractures
-Elbow extension is needed for transfers
and
weight shifting
What falls under the umbrella of
Pervasive
Development Disorders (PDD)?
-Autism
-Asperger's Syndrome
-Rett's Syndrome
-PDD not otherwise specified (Usually
when
autism is suspected but not proven)
What food consistency is most difficult
to
swallow?
Foods that have liquid and solid
consistencies are
hardest to chew and swallow.
What functional activity can a person at
Allen's
Cognitive Level II do?
Poor imitation of posture
What functional activity can a person at
Allen's
Cognitive Level III do?
Sand wood
What functional activity can a person at
Allen's
Cognitive Level IV do?
Matching colors of clothing
What functional activity can a person at
Allen's
Cognitive Level V do?
Understand cause and effect
What functionality does a person with
C1-C3 SCI
have?
-Individuals required using a respirator
-Individuals might have limited head
and neck
movement
-Able to use "sip and puff" wheelchair
-Completely dependent in ADLs and
transfers
What functionality does a person with
C4 SCI
have?
-Person has full mobility of the head and neck
-Able to breathe independently with low
stamina
-Complete body paralysis below neck
-Possibility of autonomic dysreflexia
-"Sip and puff" wheelchair required
-Completely dependent in ADLs and transfers
What functionality does a person with
C5 SCI
have?
-Good elbow flexion in order to self feed (with a
mobile arm support)
-Supination available
-No finger or wrist movement
-Breathes independently with low stamina
-Electric wheelchair may be used with hand
Control
What functionality does a person with
C6 SCI
have?
-Complete paralysis of legs and torso.
-Able to extend wrist and flex the elbow.
-Independent in transfers from toilet to wheelchair.
-Able to reach forward.
-Benefits from splint to promote wrist tenodesis.
-Able to do some ADLs such as shaving and
dressing upper body.
-Assistance may be required to dress lower body.
-Needs assistance to transfer from bed to
wheelchair.
What functionality does a person with
C7 SCI
have?
-Elbow extension available
-Wrist flexion available
-Finger extension available
-Mod I feeding
-Dress Mod I to min assist
-Bathing & Grooming Mod I
-Toileting Mod I
-Transfers Independent
What functionality does a person with
C8-T1 SCI
have?
-Full UE control including fine
coordination and
grasp
-ADLs mobility and communication are
Mod I
What functionality does a person with L4
SCI
have?
-Hip flexion and knee extension
-Independent in all activities plus
ambulation
-Bowel and bladder control is not
voluntary
What functionality does a person with
T6 SCI
have?
-Increased endurance
-Larger respiratory reserve
-Pectoral girdle stabilized for heavy
lifting
-ADLs Independent (No assistive devices)
-Uses braces with great difficulty for
ambulation
What functionality does a person with
T12 SCI
have?
-Improved endurance and trunk control.
-ADLs and IADLs and independent
-Mobility: Ambulates with long leg braces and
crutches
-Uses wheelchair for energy conservation
What group format is most appropriate
for eating
and adjustment disorders?
Psychoeducation groups
What immobilizing splint is used for
radial nerve
palsy?
Volar or dorsal 15-30 degrees of wrist
extension
What immobilizing splint is used for
reflex
sympathetic dystrophy (CRPS)?
-Volar in extension as tolerated
-Circumferential wrist might be used to
avoid
Edema
What immobilizing splint is used for
rheumatoid
arthritis?
-Volar in extension up to 30 degrees
based on the
person's comfort level
-Ulnar drift close to neutral during early
stages
What immobilizing splint is used for
tendinitis/tenosynovitis?
Volar or dorsal 20-30 degrees of wrist
extension
What immobilizing splint is used for
wrist
fracture?-Volar dorsal or circumferential.
-Maximum passive extension up to 30
degrees.
What is a advisory leadership style
(groups)?
-Therapist functions as a resource
-Members set the agenda and structure
-Members have a high skill level
-Used in mature groups
-Goal: Have members understand and self-direct
the process
What is a blocking splint used for?
Used to isolate tendon and joint range of
motion
What is a Bouchard's node?
Osteophyte formation on the PIP
What is a bunny hop pattern?
A bunny hop pattern is a result of
symmetric tonic
neck reflex utilization in order to elicit
movement
at the hips and elbows for mobility.
What is a C-bar splint used for?
-Used to maintain
webspace
-No joint
Stabilization
What is AC MRDD? Accredidation Council for Services for
Mentally
Retarded and Developmentally Disabled
What is a Colles' fracture?
Fracture to the distal radius
What is a conduct disorder?
Conduct disorders often involve aggression toward
people or animals and property destruction
What is a cooperative group?
-Facilitative leadership
-Goal is to acquire skills
-Not focused on completing task
-Feeling expression encouraged
-Therapist acts as advisor
What is a deep partial-thickness burn?
-Deep second degree burn
-Involves epidermis and the dermis
-Mottled areas of red and white eschar (dead tissue
that sloughs off of healthy skin)
-May be painful
-Hypertrophic scarring and contractures
-May need skin grafting
What is a developmental group?
A continuum of groups consisting of
parallel
project egocentric cooperative
cooperative and
mature
What is a developmental group?
(Type of activity group)
-Purpose is to develop interaction skills
for
parallel project egocentric cooperative
cooperative mature groups
What is a developmental project group?
-Has a directive leader
-Focus is on group interaction
-Individuals work on initiation sharing
short-term
tasks (ie - collage) and working with two
people
What is adhesive capsulitis?
-AKA Frozen shoulder
-Painful condition caused by immobility and
disuse
-Condition lends itself to formation of fibrous
tissue inside joint capsule
What is adiadochokinesis?The inability to perform rapid
alternating
movements such as
pronation/supination.
What is a directive leadership style
(groups)?
-Therapist is responsible for planning and
structuring
-Members have limited cognitive social and
verbal skills
-Used in parallel and project group levels
-Goal: Task accomplishment
What is a facilitative leadership style
(groups)?
-Therapist shares responsibility with the
members
-Members' skill level is moderate
-Used in egocentric cooperative or
cooperative
groups
-Goal: Skill acquisition through experience
What is affect? The observable component of emotion
What is a FIM level of "Maximal
Assistance" or
level 2?
The person puts forth less than 50% of
the effort
necessary to do a task but at least 25%
What is a FIM level of "Minimal Contact
Assistance" or level 4?
The person puts forth 75% or more of
the effort
necessary to do a task and requires no
more help
than touching.
What is a FIM level of "Moderate
Assistance" or
level 3?
The person puts forth between 50% and
75% of
the effort necessary to do a task and
requires no
more than helping or touching.
What is a FIM level of "Modified
Independence"
or level 6?
No helper is needed and the person needs an
assistive device. This score can also be
obtained
when no help is needed but the person takes
considerable time to do a task or may
complete the
task in an unsafe manner.
What is a FIM level of "Supervision or
setup" or
level 5?
The person only needs someone to
standby and
cue or coax him/her (without physical
contact) so
that he/she can do a task.
What is a FIM level of "Total Assistance"
or level
1?
The person puts forth less than 25% of
the effort
necessary to do a task.
What is a FIM level of "Total
independence" or
level 7?
No helper is needed and the person performs the
task safely within a reasonable amount of time
and without assistive devices aids or changes.
What FIMS score would be given to a person who
needs a helper to set up items or assistive devices?,
A score of "5" or "Supervision or setup" can be
obtained if a helper is needed to set up items or
assistive devices for the person.
What is a first-degree burn?
-Superficial burn involving the epidermis
-Caused by sunburn and minor flash injuries
-No edema no blisters
What is a full-thickness burn?
-Third-degree burn
-Destruction of epidermis dermis and
subcutaneous tissues
-Adipose tissue may be exposed
-Skin appears dry and leathery
-No pain
-Require skin grafting
What is a GAF scale of 0? 0: Not enough information available to
provide
GAF.
What is a GAF scale of 91 - 100?
91-100: Superior functioning in a wide
range of
activities life's problems never seem to
get out of
hand. No symptoms.
What is agnosia?
Agnosia is a category of defecits where the patient
lacks recognition of familiar object as perceived
by the senses. This could involve all the senses and
manifests with problems in body scheme such as
somatognosia and anosognosia.
What is agraphia (a.k.a. dysgraphia)? The inability to write
What is a Heberden's node?
Osteophyte formation in the DIP
What is a Laissez-Faire leadership style?
Laissez-Faire is a "hands off" approach.
Goals are
not stated the purpose is not clear
members are
not discouraged or encouraged. This is
for a
high-functioning group.
What is alexia?
Inability to understand written language
What is a mature group?-Therapist acts as equal group member
-Advisory type of leadership
-Goal is for members to self direct
-Requires end product and time limit
What is an appropriate approach to take
with a
child with behavioral problems?
Provide enjoyable activities in a safe and
accepting
Environment
What is a Needs Assessment?
-Describes community factors and
populations at
risk
-Target population demographics
functional
levels disorders
What is an egocentric-cooperative
group?
-Facilitative leadership
-Focuses on acquiring skill
-Not focus on task completion
-Long-term tasks (ie-mosaics)
What is a neuroma?
A ______ is an unorganized mass of nerve fibers
resulting from a laceration (either surgical or
accidental) or amputation in which the nerve
regrows in unorganized bundles. Results in sharp
radiating pain.
What is an evalutation group?
(Type of activity group)
-Purpose is to assess skills and limitations
regarding group interaction
-For indiv's who lack group interaction skills
-The therapist does not participate or
intervene
(only acts as observer)
What is an instrumental group?
(Type of activity group)
-Purpose is to help functioning at highest level
and
meet mental health needs
-Intended for individuals who have an ability to
change or progress
-Therapist acts as supporter and is unconditional
-Activities focus on maintaining function
What is an instrumental group?
-To help members function at their
highest
possible level
Goal: prevent regression maintain
function and
meet mental health needs
Type of member: high functioning
What is an intervention strategy for
motor/ideomotor apraxia?
Provide hand over hand tactile-
kinesthetic input
and utilize visual cues
What is an opponens splint?
-May be short or long
-Supports the thumb in a position of abduction and
Opposition
What is anosognosia?
Anosognosia: Transient severe form of neglect.
Patient does not recognize the presence or severity
of his paralysis.
What is another name for reflex
sympathetic
dystrophy?
Complex regional pain syndrome.
What is anterior cord syndrome?
Often associated with
a lesion causing
variable loss of
motor and sensation
function.
Proprioception
preserved.
What is anterograde amnesia?
Inability to remember ongoing events after
the
incidence of trauma or the onset of the
disease that
caused the amnesia but able to remember
incidents that happened before the incident
What is antisocial personality disorder?
-Must be at least 18 years or older
-Engage in illegal activity
-Unemployed aggressive impulsive
irresponsible
-Lack of remorse
What is a parallel group?
-Has a directive leader
-Focuses on task completion
-No interaction
-Indiv's are low level
-Work on trust awareness comfort
What is a postural or orthostatic
hypotension?
-Common in T6 and above injuries
-Light headedness dizziness and/or fainting when
moving from reclined to upright position
-Patient must recline quickly
What is apraxia?
Loss of the ability to execute or carry out learned
(familiar) movements despite having the desire
and the physical ability to perform the movements
What is a program evaluation?A program evaluation is the compilation
of the
intervention results for a population of
individuals.
What is a reasonable accomodation?-Undue hardship in relation to
company's assets
-Applies to companies with 15+
employees
What is a resting hand splint used for?
-RA Burns Dupuyten's and RSD
-Supports the hand and wrist joint so that they heal
without contracting and so that a deformity does
not develop
What is Arnold-Chiari Syndrome?
-Cerebellum and medulla oblongata slip through
foramen magnum of skull
-Typically results from spina bifida
What is a rotator cuff tear?
-Often requires surgical repair
-Tear to the supraspinatus tendon
-Surgery not usually performed unless more than
50% of the muscle is torn
What is Arthrogryposis?
Arthrogryposis or arthrogryposis multiplex
congenita comprises nonprogressive conditions
characterized by multiple joint contractures found
throughout the body at birth
What is Asperger's Syndrome? Has similar characteristics to autism.
Sometimes
referred to as high functioning autism.
What is astereognosis?
The inability to identify objects through touch
What is a superficial partial-thickness
burn?
-Second degree burn
-Involves epidermis and papillary dermis
-Skin is moist weepy and blistered
-Edema is present
-Very painful type of burn
-No scarring
What is a symmetric tonic neck reflex?
When an infant's neck is extended the elbows
extend and the hips flex. When the head is
lowered the elbows flex and the hips extend.
What is a task-oriented group?
(Type of activity group)
-The purpose is to increase awareness of needs
values ideas feelings behaviors
-Intended for indiv's with disfunction in cognition
and social-emotional areas (psych or physical
trauma)
-Used for substance abuse
-Therapist is initially active and provides structure
-Activities create an end product
What is ataxia?
______ describes a lack of coordination while
performing voluntary movements. It may appear
as clumsiness inaccuracy or instability.
What is ataxic CP?
-Ranges from near normal to normal
-Increased tone usually involves lower
extremity
flexion
-Most functional form of CP
What is a thematic group?
(Type of activity group)
-Purpose is to acquire knowledge and skills to
perform a specific activity
-For indiv's who have minimal interaction skills
-Therapist selects structures and grades activities
-Therapist acts as advisor
-Activities directly relate to skills (ie-cooking
group parallel group)
What is a topical group?
(Type of activity group)
-Purpose is to discuss activities engaged outside of
group
-For individuals who share similar problems in
functioning (ie-egocentric cooperative level)
-Therapist acts as a role model and shares
leadership
-Activities include verbal discussion and roleplay
What is auditory agnosia?
Inability to recognize sounds words and
non-words.
What is a utilization review?Process of analyzing the provision of
services to
promote the most economical delivery
service
What is autism?
Symptoms include:
-Impairments of social interaction social
communication social behavior
-Inability to relate to others
-Echolalia
-Flat affect and poor eye contact
-Aversion to physical contact
-Ritualistic and repetitve behaviors
-Intolerance to changes in routine
What is autocratic leadership? The leader exerts complete control.
What is avoidance personality disorder?
-Social discomfort
-Avoidance of interpersonal
relationships is
common
-Fear of disapproval
What is a Volkmann's contracture?
A fracture of the distal end of the humerus that
interferes with blood supply of the forearm
What is Axis III in the DSM-IV?
General medical conditions
What is Axis II in the DSM-IV?
MR & personality disorders
What is Axis I in the DSM-IV?
Clinical disorders/psych diagnoses
What is Axis IV in the DSM-IV?
Psychosocial & environmental problems
What is Axis V in the DSM-IV?
GAF Score
What is ballism?
Rare symptom that is produced by
continuous
abrupt contractions of the axial and
proximal
musculature of the extremity.
What is borderline personality disorder?
-Impulsive
-Mood instability
-Inappropriate affect
-Suicidal ideations
-Self mutilation
-Fear of abandonment
What is bradykinesia?
Bradykinesia means "slow movement."
What is Broca's Aphasia?
-Characterized by frontal lobe damage resulting in
speech apraxia and agrammaticism
-The individual has good auditory comprehension
but reading and writing are severely affected
What is Brown-Sequard syndrome?
A hemisection lesion
of the cord resulting
in ipsilateral motor
loss and contralateral
loss of sensitiv ity to
pain and temp.
What is bursitis and tendonitis of the
shoulder
complex?
-Affects the shoulder when the bursa
and synovial
sheaths become inflamed from overuse
What is carpal tunnel syndrome?
-Caused by inflammation of the median nerve at
the wrist
-Causes numbness tingling and pain in thumb
index and middle fingers
-May result in thenar atrophy
What is cauda equina syndrome?
Due to injury of
lumbosacral nerve
roots in spinal canal.
Leads to areflexic
bladder bowel and
lower limbs.
What is central cord syndrome?
Central injury to
cervical spinal cord
resulting in greater
weakness in UEs
than in LEs.
What is cerebral palsy?
A permanent impairment affecting automatic
postural control and movement as a result of a
non-progressive brain disorder
What is chorea?
Irregular purposeless involuntary quick jerky
and dysrhythmic movements of variable
distribution.
What is choreoathetosis?
____________ is a movement of
intermediate
speed fluctuating between the quick
flitting
movements of chorea and the slower
writhing
movements of athetosis.
What is close OT supervision? Reporting once per day
What is "close supervision" defined as? Close supervision is defined as "daily
direct
contact at the site of work"
What is conceptual age of a fetus? Age of fetus or newborn in weeks since
conception
What is conduct disorder?
A disregard for the rights of others
leading to
aggression towards people and animals
destruction of property deceitfulness
theft or
serious violation of rules
What is constructional apraxia?
Unable to produce designs in 2 or three
dimensions by copying drawing or constructing.
What is conus medullaris syndrome?
Assoc. with injury to the sacral cord and lumbar
nerve roots. Patients present with areflexic
bladder bowel and lower limbs. Sacral segments
sometimes show preserved reflexes.
What is cover under Medicare Part B?
-Covers hospital outpatient physician
and other
professional services including OT
-Consider supplemental
-Must be purchased as a monthly
premium
What is creative play? -4 - 7 years
-Child participates in cooperative peer
groups
What is cubital tunnel syndrome?
-Compression or entrapment of the ulnar nerve as
it courses around the medial epicondyle of the
elbow
-Cubital is behind the "funny bone"
-Numbness and tingling in the ring and small
Fingers
What is defined as therapeutic use of
self?
The therapist's conscious planned
interaction with
the individual family members
significant others
and/or caregivers
What is delirium?
A disoriented reaction with restlessness
and
confusion that may be associated with
fear and
hallucinations
What is delirium?
-Impairment of consciousness with
global
cognitive impairments
-Lability
-Hallucinations
What is dementia?
-Commonly seen in Alzheimer's head trauma
Parkinson's and Huntington's
-Multiple cognitive deficit including memory loss
and impaired consciousness
What psychiatric symptoms can be present in
Huntington's
Psychotic Features
What is democratic leadership?
This style can be a problem-solving
style.
Group members feel safe to express
views
thoughts and feelings.
What is dependent personality disorder?
-Most common personality disorder
-Individuals believe they can not survive without
relationships
-Desire to win approval and avoid abandonment
-Submissive
-Difficulty making decisions
-Fear of being alone
What is De Quervain's Syndrome?
-Tendonitis of the first dorsal compartment near
the anatomical snuffbox
-Caused by overuse of the thumb
-Tested with finklestein's
What is disorganized type
schizophrenia?
Primitive disinhibited and disorganized
behavior
What is Duchenne's Muscular
Dystrophy?
-Progressive disorder in which weakness occurs in
all voluntary muscles including the heart
-With Duchenne's individuals rarely survive
beyond early 20s
-Focus on energy conservation breathing
techniques I in ADLs maintaining/increasing
ROM
What is Durable Medical Equipment
(DME)?
Items that can withstand repeated use
such as a
wheelchair medical bed and walkers.
What is dysarthria?
Explosive or slurred speech caused by
incoordination of muscles involved in speech.
Classified as a neuromotor problem.
What is dysgraphia?
Inability to print or write
What is dysmetria?
Dysmetria is the inability to estimate the ROM
necessary to meet the target. Evident when the
individual tries to touch the nose.
What is dyspraxia?
Difficulty in planning new motor tasks
What is dystonia?
________ is a neurologic movement disorder
characterized by sustained muscle contractions
usually producing twisting and repetitive
movements or abnormal postures or positions.
What is echopraxia?
The meaningless imitation of another
person's
Movements
What is exploratory play?-0 to 2 years
-play experience develops body scheme
-child explores properties and effects of
actions
What is extrapyramidal syndrome?
Extrapyramidal syndrome is a neurological side
effect of anti-psychotic medication that mimics the
effects of Parkinson's disease. This can cause
rigidity bradykinesia cogwheel and leadpipe
rigidity loss of postural mechanisms and a
resting pill-rolling tremor.
What is functional skill training?
Focuses on mastery of a specific task.
Requires
client to repeatedly practice the
substeps of a task
with the # of cues for each task
gradually faded
out.
What is general OT supervision? Once a month
What is gestational age of a fetus?
Age of fetus or newborn in weeks from first day of
mother's last normal menstrual period
What is Guillain-Barre syndrome?
An autoimmune disease in which the peripheral
nerves become inflammed. Results in numbness
and paralysis in the legs upper body and face.
Level of independence depends on extent of
paralysis.
What is heterotrophic ossification?
-Abnormal deposition of osseous material in the
hip knee elbow and shoulder
-Symptoms include: heat pain swelling
decreased ROM and fever
-Usually appears 1-4 months post traumatic injury
such as TVA
What is histrionic personality disorder?Characterized by colorful dramatic extroverted
behavior in excitable emotional persons. Inability
to maintain deep long-lasting attachments with
accompanying flamboyant presentation is often
characteristic
What is histrionic personality disorder?
-Theatrical
-Center of attention
-Extreme emotionality
-Approval seeking
-Low frustration tolerance
-Unable to delay gratification
What is Huntington's Chorea?
Characterized by choreiform movements and
progressive intellectual deterioration
What is Huntington's Disease?
The classic signs of HD include the development
of chorea-or involuntary rapid irregular jerky
movements that may affect the face arms legs or
trunk-as well as the gradual loss of thought
processing and acquired intellectual abilities
(dementia).
What is ideational apraxia?
The disability of carrying out complex sequential
motor acts. Caused by a disruption of the
conception rather than execution. (Loss of tool
function knowledge)
What is identification? Taking on the character of another
person
What is ideomotor apraxia?
Inability to imitate gestures or perform a
purposeful motor task on command even though
the patient is able to fully understand the idea or
concept of a task. This is often associated with left
hemisphere damage.
What is included in Performance Skills
(Practice
Framework)?
-Motor Skills
-Process Skills
-Communication/Interaction Skills
What is included in the Activity
Demands of the
Practice Framework?
-Objects used and their properties
-Space Demands
-Social Demands
-Sequencing and Timing
-Required Actions
-Required Body Functions
-Required Body Structures
What is included in the Client Factors of
the
Practice Framework?
-Body Function
-Body Structure
What is included in the Context of the
Practice
Framework?
-Cultural
-Physical (Environment)
-Social
-Personal(socioeconomic age)
-Spiritual
-Temporal
-Virtual
What is included in the Performance
Areas of
Occupation (Practice Framework)?
-ADLs
-IADLs
-Education
-Work
-Play
-Leisure
-Social Participation
What is included in the Performance
Patterns
(Practice Framework)?
-Habits
-Routines
-Roles
What is intrinsic plus grasp?
Characterized by:
-All the MPs in flexion
-DIPs and PIPs full extension
-Thumb in opposition to MF & RF (ie-
holding a
plate)
What is lateral epicondylitis?
-AKA Tennis Elbow
-Insertion point of the extensor carpi radialis
brevis becomes inflammed
-If left untreated can tear requiring surgical repair
What is level five of meal preparation? Two hot meals
Example: Chicken and mashed potatoes
What is level four of meal preparation? Hot one dish meals
Example: Macaroni and cheese
What is level one of meal preparation? Very simple
Example: Pouring glass of OJ
What is level three of meal preparation? Soups frozen dinners hot beverages
What is level two of meal preparation? Preparing simple step meals
Example: Peanut butter jelly and instant
pudding
What is medial epicondylitis?
-AKA Golfer's Elbow
-Caused by forceful and repeated flexion of the
wrist and fingers
What is minimal OT supervision? As needed
What is narcissistic personality
disorder?
-Grandiosity
-Attention seeking
-Lack of empathy
-Egomaniac with inferiority complex
What is nystagmus?Involuntary movement of the eyeballs in an
up/down back/forth motion. Interferes with
head
control.
What is obsessive-compulsive
personality
disorder?-Potentially most disabling
-Perfectionistic
-Rigid
-Ritualistic behavior
What is occupational performance?Ability to carry out ADLs. Evaluation
looks at
activity demands client factors and
environment.
What is olecranon bursitis?
-When the olecrenon bursa of the elbow becomes
inflammed due to contact pressure or overuse
What is oppositional defiant disorder? Negativistic hostile and defined
behaviors that
result in functional impairment
What is oral apraxia?
Difficulty in forming and organizing intelligable
words though the musculature required to do so is
in tact. Differs from disarthria because no muscles
are affected and speech is not slurred.
What is osteoarthritis?
-Non-inflammatory
-Cartilage destruction
-Progressive
-Usually occurs due to old age
What is parasthesia?
Sensation of tingling itching numbness or
burning caused by sustained nerve pressure or
reduced blood flow.
What is Pes Valgus?
Pes Valgus (Pronated
Foot)
What is pes varus?
Club foot (Supinated
foot)
What is Program Evaluation?
-Systematic review and analysis of care
provided
to determine if care is at an acceptable
level of
quality
What is Program Implementation?
-Initiates program according to time
table and
steps set forth in the program plan
-Promote program to ensure it reaches
target
Population
What is Program Planning? -Defines focus for a program based on
needs
assessment results
What is projection? Blaming others for one's behaviors
What is pronator teres syndrome?
- numbness in median nerve distribution
- entrapment (compression or pinching) of the
median nerve at or about the level of the elbow
- Symptoms: median nerve compressed at or just
above the elbow results in weakness of the
pronator teres muscle
- Median nerve entrapment at the elbow is a rare
more commonly seen in children
What is prosopagnosia?
Face blindness. Inability to identify an individual
by their face.
What is pulled elbow syndrome?
- common injury in children under five years
- dislocation of the elbow by a sudden jerk
upwards of the arm
What is Ranchos Los Amigos Cognitive
Scale
Level I?
NO RESPONSE
Person does not respond to sounds
sights touch or
movement.
What is Ranchos Los Amigos Cognitive
Scale
Level II?
GENERALIZED RESPONSE
-Begins to respond to sounds sights touch or
movement
-May open eyes but does not focus on anything in
paricular
-Respond slowly inconsistently or after a delay
-Responses may include chewing sweating
breathing faster increased BP etc.
What is Ranchos Los Amigos Cognitive
Scale
Level III?
LOCALIZED RESPONSE
-Patients begin to move their eyes and look at
specific people and objects
-Turn heads in the direction of loud voices of
noise
-Can follow simple commands such as "Squeeze
my hand"
What is Ranchos Los Amigos Cognitive
Scale
Level V?
CONFUSED AND INAPPROPRIATE
-Patient is confused and does not make sense in
conversations but may be able to follow simple
directions
-May get upset when stressed but agitation is no
longer a major problem
-Frustration as elements of memory may return
What is Ranchos Los Amigos Cognitive
Scale
Level VI?
CONFUSED BUT APPROPRIATE
-Speech makes sense
-Able to perform self care
-Poor initiation and termination in
activities
-Learning difficult
What is Ranchos Los Amigos Cognitive
Scale
Level VII?
AUTOMATIC APPROPRIATE
-Patients are usually coherent
-ADLs independent
-Difficulty remembering recent events and
discussions
-Difficulty with calculations problem solving
judgment
-Aware of deficits
What is Ranchos Los Amigos Cognitive
Scale
Level VIII?
PURPOSEFUL AND APPROPRIATE
-Patients are independent and can process
new
information
-Able to remember distant and recent events
and
can figure out complex and simple problems
What is Ranchos Los Amigos Coma Scale
Level
IV?
CONFUSED AND AGITATED
-Patient is confused and agitated about where
they
are and what is hapening in the surrounding
-At the slightest provocation patient may
become
restless agressive or verbally abusive
What is rationalization? Making excuses for behaviors that are
considered
Unacceptable
What is reality orientation? Awareness of date and time
What is reflex sympathetic dystrophy?
__________ is caused by trauma post-surgical
inflammation infection or laceration to an
extremity. Characterized by pain edema shiny
skin blotchy skin and excessive sweating or
dryness.
What is reliability? Establishes the consistency of the
evaluation
What is retrograde amnesia?
Inability to remember events that
occurred before
the incidence of trauma or the onset of
the disease
that caused the amnesia
What is rotation? A type of in-hand manipulation that is
displayed
when an individual turns a nut on a bolt.
What is rotator cuff tendonitis?
-Acute painful condition affecting the
supraspinatus and sometimes infraspinatus tendons
-Pain with external rotation and mid-range
Abduction
What is routine OT supervision? Reporting every two weeks
What is schizoid personality disorder?Individuals who display a lifelong pattern of social
withdrawal. Marked by this cover with human
interaction in conversion and bland constricted
affect. Often seen by others as eccentric isolated
or lonely
What is schizoid personality disorder?
-Characteristics are limited emotional
range
-Absense or indifference to social
activity
-Withdrawn
-Self absorbed
What is schizotypal disorder?
-Same features as schizophrenia but to lesser
degree
-Cognitive impairment primarily in working
memory verbal learning and sustained attention
What is somatognosia? Lack of awareness of one's body parts.
What is spina bifida with meningocele?
Protrusion of a sac through the spine containing
CSF and meninges, does NOT include spinal cord
What is spina bifida with
myelomeningocele?
Protrusion of a sac through the spine containing
CSF and spinal cord/nerve roots
What is spinal shock?
Transient physiological reaction to depression
of
the cord below the SCI level. Associated loss of
sensorimotor function and flaccid paralysis.
Flaccid paralysis symptoms last several days.
What is stage four of OT treatment?
Occupations. The highest stage of treatment
continuum engages the patient in natural
occupations in their living environment and
the
community. Not all patients can achieve this
stage.
What is stage three of OT intervention?
Purposeful activities: Evaulate performance
areas.
Have inherent autonomous goals and are
relevant
and meaningful to the patient such as ADLs
IADLs etc. Used to evaluate facilitate restore or
maintain a person's ability to function in life roles
What is sundowning?
Occurs in the late afternoon and at night in older
individuals. Characterized by drowsiness
confusion ataxia and falling.
What is symbolic play?-2 to 4 years
-Play helps to formulate test classify and
refine
Ideas
What is tardive dyskinesia?
Tardive dyskinesia is a neurological syndrome
caused by the long-term use of neuroleptic drugs.
Tardive dyskinesia is characterized by repetitive
involuntary purposeless movements. Features of
the disorder may include grimacing tongue
protrusion lip smacking puckering and pursing
and rapid eye blinking. Involuntary movements of
the fingers may appear as though the individual is
playing an invisible guitar or piano.
What is the Assessment component of a
SOAP
note?
-Involves professional judgment
-Provides opportunity for OT to draw conlcusions
from S and O
-Inconsistencies between patient's complaints and
the objective findings can be discussed
-Comments can be made regarding patient's
progress in therapy (ie - Pt. refused to participate
in tx.)
-Reasoning for information not obtained can be
listed (ie - too much pain to complete session)
What is the best way to obtain detailed
information
about an individual's job requirements?
By examing a job analysis. A job analysis
is a
detailed description of the physical
sensory and
psych demands of a job.
What is the comprehensive occupational
therapy
evaluation (COTE)?
Evaluates general interpersonal and task
behaviors pertenent to OT
What is the development of
sensorimotor
integration in the first six months?
-Infant movement patters progress from
reflexive
to voluntary and goal directed
-Vestibular proprioceptive and visual integrate
for postural control
-Visual and tactile systems become integrated to
lay foundation for eye-hand coordination
What is the development of sensorimotor
What is the development of
sensorimotor
integration in the prenatal period?
1) responds to tactile stimuli
2) reflex development
What is the development of
sensorimotor
What is the diagnostic criteria for a
major
depressive episode?
A two-week period of depressed mood
or loss of
interest or pleasure
What is the diagnostic criteria for
dysthymic
disorder?
More than two years depressed for most
of the
day.
What is the diagnostic criteria for major
depressive
disorder?
Must present with either depressed
mood or loss of
interest or pleasure. Can be a single
episode.
What is the difference between a
hallucination and
a dillusion?
-During hallucinations indiv's sense (see hear
etc) a non-existent external stimulus and with
a
compelling sense of their reality
-Dillusions are misinterpretations of external
Stimuli
What is the difference between
Medicare Part A
and B?
-Inpatient Part A requires service for a
minimum
of 5 days per week
-Part B covers 3 days of outpatient
What is the difference between oral
apraxia and
dysarthria?
Dysarthria is a neuromotor disorder
affecting the
muscles of the face whereas oral apraxia
(such as
Broca's aphasia )is purely neurological.
What is the difference between
rheumatoid and
osteoarthritis?
-RA is an inflammatory systemic
autoimmune
disorder
-OA is regionalized to specific joints and
can be
caused by trauma overuse and old age
What is the fifth component of a goal?
Function: Similar to behavior but
justifies the
reason for treatment. (ie - to open a door
use a
computer etc)
What is the first component of a goal?
Person: The person who will do the behavior
What is the second component of a goal?,
Behavior: What the individual is expected to
perform.
-Must be observable measurable and
functional
Behavior
What is the first level of OT intervention?
Adjunctive methods. These are preliminary to the
use of purposeful activities and may include
exercise facilitation and inhibition techniques
positioning sensory stim PAMs and splints.
-OTs evaluate performance components (innate
abilities)
What is the fourth component of a goal?
Criterion: Standard the client must meet.
-How well they must perform in order to
achieve
goal/objective.
-Has to be quatifiable (number or responses
degree of ROM length of time amount of
assistance provided etc.)
What is the functional position of the
hand?
-Wrist 20 to 30° of extension
-MCPs 45° flexion
-IPs 20 to 30° of flexion
-Thumb in palmar abduction
What is the functional position of the
hand?
-Wrist: 30 degrees in extension
-Phalanges: Slight flexion
-Thumb: Opposed to index finger
What is the GAF scale?
The Global Assessment of Functioning (GAF)
scale is a numeric scale (0 through 100) used in
mental health to rate the social occupational and
psychological functioning of adults. (DSM-IV)
What is the Glasgow Coma Scale?
-A brain injury severity scale that assesses depth
and duration of impaired consciousness and coma.
-Used by clinicians to gauge deterioration or
improvement at the emergent and acute stages of
brain damage or lesions.
-Predicts ultimate functional outcome.
What is the global assessment of
functioning scale
(GAF)?
A numeric scale from 0 to 100 that rates
the social
occupational and psychological
functioning of
adults. This is axis five of the DSM-IV
What is the Kohlman Evaluation of Living
Skills?
(KELS)
Assesses basic living skills using interview and
Test
What is the main goal during the acute
phase in
mental health?
Stabilization
What is the main goal during the
chronic phase of
mental health?
-Focus on compensatory techniques and
environmental adaptations
What is the main goal during the rehab
phase of
mental health?
-Functional activities
-Performance components
What is the main goal during the
subacute phase in
mental health?
-Enabling activities
-Performance components
What is the minimum doorway width for
a
wheelchair?
32"
What is the National Alliance for the
Mentally Ill?
Provides support groups open to clients
& families
with a focus on education and support
for mental
illness.
What is the Objective component of a
SOAP note?
-Result of the therapist's objective
measurements
or observations
-IE: ROM MMT FIMs evaluate speed of
transfers and the movement of each
body part and
assistance required
What is the optimum number of
members for a
counseling group?
No more than eight members.
What is the optimum number of
members for a
therapy group?
Five to six.
What is the "partnership" type of mental
health
service delivery?
-Clients are informed that they are
partners in the
service
-The distinction between professionals
and clients
remain clearly defined
What is the Plan component of a SOAP
note?
- The Plan states the frequency of treatment (per
day or week)
- Tx plan LTG & STG
- Discharge plan
- Referral to other disciplines
- DME & AE needed to order
- Plans for further assessment
What is the position of deformity?-Wrist flexion
-MCP hyperextension
-IP joints flexed
-Thumbs adducted
What is the post-traumatic amnesia
classification
tool?
A classification tool used by clinicians to
assess
the severity of injury.
What is the protocol for a contrast bath?
-Begin in warm water for 10 minutes
-Move hand to cold water for 1 minute then back
to warm for four minutes
-Continue for 15 to 30 minutes and end in warm
water
-In severe case of edema end in cold water for 1
Minute
What is the purpose/focus of a
(developmental)
cooperative group?
-Enables members to engage in group
activity to
facilitate expression
-Members' cognitive level: Medium
-Leadership style: facilitative
Goal: acquire skills
What is the purpose/focus of a
(developmental)
egocentric-cooperative group?
-Enables members to select and implete a
long-range activity (i.e.: grout with tiles drying)
-Requires group interaction
-Members' cognitive level: Medium
-Leadership style: facilitative
Goal: acquire skills
What is the purpose/focus of a
(developmental)
mature group?
-Enable members to assume all
functional
socio-emotional and task roles within a
group
-Members' cognitive level: high
-Leadership: advisory
-Goal: help members self-direct
What is the purpose/focus of a
(developmental)
parallel group?
-To enable members to perform
individual
activities in the presence of others
-Leadership: directive
-Members' cognitive level: low
What is the purpose/focus of a
(developmental)
project group?
-To develop the ability to perform a shared
short-term activity in a cooperative manner
-Members' cognitive level: low
-Leadership: directive
-Goal: group interaction
What is the purpose/focus of a task-
oriented
group?
-To increase clients' awareness of their needs
values ideas feelings and behaviors as they
engage in a group task
-Members' primary dysfunction is cognitive and
socioemotional due to psychological or physical
trauma
What is the purpose/focus of a
therapeutic group?
-Assist members in acquiring the knowledge
skills and/or attitudes needed to perform a
specific
activity
-Members must have interaction skills equal
to a
parallel group skill level
What is the purpose/focus of a topical
group?
-Discuss activities outside of group
-Members must be at an egocentric-
cooperative
group skill level
-Therapist shares leadership and acts as
role model
What is the purpose of an evaluation
group?
-Assess client's skills assets and
limitations
regarding group interaction
What is the rehabilitation model?
The rehabilitation model goal is to help
the patient
learn to work arond or compensate for
physical
cognitive or perceptual limitations.
What is the remotivation approach? -Using memories from pictures and
music to
remotivate patients
What is the role of OT in the ADA?
-Prepare clients for disclosure
-Identify qualifications
-Focus treatment to identify limitations
-Educate client
-Advocate and educate employer/public
What is the SEC?
Standards and Ethics Commission: a
component of
AOTA responsible for the code of ethics
and
standards of practice of the profession
What is the second stage of OT
intervention?
Enabling activities. May not yet be considered
purposeful activities but are steps toward
performance of purposeful activities.
-Performance components and areas
(Dressing
using adaptive equipment)
What is the "separist" type of mental
health service
delivery?
-Ex-patients provide the support and
run the
service
-Non-patients and professionals are
excluded
What is the splint for radial nerve palsy?
-Dynamic dorsal splint for wrist extension MCP
extension and thumb extension
What is the standard height of a
wheelchair seat?
18". Toilets are typically 15" and should
be raised
to accommodate transfers.
What is the Subjective component of a
SOAP
note?
-What a patient or significant other states
-What the patient or significant other states
about
their medical history emotions lifestyle home
situation
-Patient-stated goals "I want to work again"
-Complaints
-Patient's assessment of treatment
What is the "supportive" type of mental
health
service delivery?
Professionals are excluded except in
external roles
What is the third component of a goal?Condition: The environmental situation in which
the behavior is performed (when where what in
what manner)
-Focus on what most affects function (ie - if a
child cannot sit "in sitting" would be the condition
What is the "traditional" type of mental
health
service delivery?
-Professionals provide the service
-Clients receive the service
What is the Tunnel of Guyon?
-Similar to CTS
-Ulnar nerve becomes entrapped between the hook
of the hamate and the pisiform bones
What is the underlying premise of PNF
technique?
Uses functional patterns of stretching in
order to
elicit proprioceptive awareness of one's
body parts
What is Tinel's sign?
-Tapping skin over damaged peripheral nerve to
elicit tingling or pins and needles
What is Title 1 of the ADA? Addresses reasonable accomodation
and
employment discrimination
What is Title 2 of the ADA? Addresses public services constructed
buildings
state and local gov't business
What is Title 3 of the ADA? -Public accomodations
-Accessible design
What is trigger finger?
-Caused by a nodule or thickening of the flexor
tendons of the finger or thumb as they pass
through the digital pulleys
-Hinders gliding motion resulting in catching or
"triggering" during flx/ext
What is underlying premise of Bobath
(NDT)
technique?
-Normal movement (ie - weight bearing)
What is underlying premise of Rood
technique?
Facilitory/inhibitory
What is undifferentiated type
schizophrenia?
Used to classify individuals who do not
fit clearly
into another subcategory of
schizophrenia
What is Valgus Stress Symdrome?
- valgus overload or overstress injury to
the medial
elbow
- occurs as a result of repetitive
throwing motions
What is validity? Determines if the tool measures what it
is intended
to measure
What is visual agnosia?
Lack of ability to recognize common objects and
demonstrate their use in an activity.
What is visual-spacial agnosia? Affects perception of spatial relationship
between
objects or between objects and self.
What is Wernicke's Aphasia?
-Characterized by temporal lobe damage resulting
in impaired auditory comprehension and feedback
-Have fluent well-articulated paraphasic speech
(word substitution errors)
What methods are used to analyze an
activity?
1) Specify exact activity
2) Idenitify procedures materials and
tools
3) Analyze standard performance of
activity
4) Use AOTA uniform terminology
5) Select frame of reference
What muscle is affected in an axillary
nerve
injury?
The serratus anterior muscle
What muscles does C5 innervate?
C5: Shoulder abduction extension and external
rotation, some elbow flexion and supination
What muscles does C6 innervate?
C6: Forearm pronation and supination some wrist
Extension
What muscles does C7 innervate?
C7: Consistently supplies the latissimus dorsi.
Elbow extension wrist flexion finger extension
What muscles does C8 innervate?
C8: Finger extensors finger flexors hand
Intrinsic
What muscles does T1 innervate?
T1: Hand intrinsic
What persons are eligible for medicare
coverage?
-65 years or older
-Permanent kidney failure
-Black lung disease
-Persons on SS program for 24 months
What postural stability must an
individual
demonstrate before being able to use a
mobile arm
support?
Lateral trunk stability
What psychiatric symptoms are present
in brain
tumors?
-Hallucinations
-Depression
-Psychosis
-Personality changes
What psychiatric symptoms are present
in
epilepsy?
-Psychosis (hallucinations)
-Fear and anxiety
What sensory region does the radial
nerve
innervate on the hand?
Radial Nerve
What should an OT do during the active
rehabilitation phase of a spinal cord
injury?
-Increase upright tolerance (Teach pressure relief
methods)
-AROM/PROM
-Contracture prevention
-Promote tenodesis
-ADL/Equipment needs
-Strengthening/graded activities
-Bowel/bladder training
-Assess need for DMEs
-Caregiver education
-Home evaluation
What should an OT do during the acute
phase of a
spinal cord injury?
-The spine is immobilized with a halo brace of
body jacket
-No flexion extension or rotary movements of the
spine and neck
-Positioning
-Hand splinting
-Active and active-assisted exercises
-PROM of joints
-Neuromuscular reeducation for wrist and elbows
if indicated
-Begin discharge planning
What should an OT do during the acute
phase of
therapeutic management in a nerve
injury?
Early post-injury/surgery phase focuses on:
-Healing and prevention
-Immobilization
Post-immobilization focuses on:
-Increasing ROM
-Enhancing function through splints and assistive
devices
-Patient education
What should an OT do during the
chronic phase of
therapeutic management in a nerve
injury?
-No further reinnervation
-Patient has significant deficits
-Focus is on compensatory skills
What should an OT do during the
extended
rehabilitation phase of a spinal cord
injury?
-Driving
-Leisure activities
-Prevocational assessment
-Home modifications
-Community reentry
-Technology use
What should an OT do during the
recovery phase
of therapeutic management in a nerve
injury?
This defines the period of reinnervation.
Focus is
on:
-Motor retraining
-Sensory reeducation
-Desensitization
What should a typical anxiety disorder
OT
intervention focus on?
OT interventions with anxiety disorders such
as
panic disorder OCD and PTSD should utilize
skills training and cognitive behavioral
approaches
as well as teaching relaxation and stress
management skills
What should a typical substance abuse
OT
intervention focus on?
Intervention should focus on developing skills for
a substance-free lifestyle. This includes
interpersonal relationships socialization and
vocation. Assistance with practical services such
as obtaining Social Security housing and food
stamps should also be a focus
What shoulder exercises are needed for
an
individual with spinal cord injury?
Focus on promoting proximal stability by
engaged:
-Shoulder depressors (lower traps
latissimus dorsi
and pectoralis minor)
-Work shoulder flexors abductors and
extensors
What should you do if you have
questions about
potential ethical violations that could
cause harm?
Call the State Regulatory Board (SRB).
NBCOT
and AOTA should be contacted if
offender falls
under their licensing jurisdiction
What splint is used for a 5-year old child
with
spastic quad CP how shows bilateral
thum-in-palm
deformities?
A neoprene hand-based splint
w/thumbs in
Opposition
What splint is used for a carpal tunnel
release
surgery?
Volar splint with the wrist in a neutral or
slightly
extended wrist position
What splint is used for median nerve
compression
(CTS)?
Dorsal volar or ulnar gutter splint
What splint is used for median nerve
palsy?
Splint to position the thumb in palmar
abduction
and opposition
What splint is used to subtitute for loss
of intrinsic
plus grasp?
-Use figure eight or dynamic flexion
splint
-Loss of intrinsic plus is associated with
median
and ulnar nerve dysfunction
What stage is initiated by looking at and
reaching
for food?
The oral preparatory phase.
What type of group structure would be
most
appropriate for individuals with
substance abuse?
A task group is appropriate for
substance abuse
disorders.
What type of spina bifida presents with
the most
symptoms?
SB with a myelomeningocele results in
sensory
and motor deficits below the level of the
lesion
and may result in paralysis
What type of splint would be crafted for
someone
with a C6-C7 spinal cord injury?
A tenodesis splint
What type of splint would be crafted for
someone
with swan neck?
Silver rings or buttonhole splint
What type of split would be crafted for a
brachial
plexus injury?
A flail arm splint
What type of split would be crafted for a
combined
median/ulnar nerve injury?
A figure of eight splint or dynamic MCP
flexion
Splint
What type of split would be crafted for a
median
nerve injury?
An opponens splint or C-Bar splint
What type of split would be crafted for
an ulnar
nerve injury?
A dynamic/static splint to position MPs
in flexion
What type of split would be crafted for
someone
with a Boutenniere deformity?
Silver rings or dynamic PIP extension
splints
What type of split would be crafted for
someone
with a flexor tendon injury?
Kleinert or Duran dorsal protection
splint
What type of split would be crafted for
someone
with arthritis?
A functional splint or safe splints
depending on
Stage
What type of split would be crafted for
someone
with CMC arthritis?
A hand-based thumb splint
What type of split would be crafted for
someone
with flaccidity?
A resting splint
What type of split would be crafted for
someone
with spasticity?
A spasticity splint or a cone splint
What type of split would be crafted for
someone
with the skiers thumb injury?
A hand-based thumb splint
What would you do if you had ten
people assigned
to your group?
Divide them into two subgroups.
What wrist exercises are needed for an
individual
with spinal cord injury?
-Wrist extension
-Focus on maximizing tenodesis with
ROM of
finger flexion with wrist extension and
ROM of
finger extension with wrist flexion
When are thumb immobilization splints
used?
-DeQuervain's Tenosynovitis
-Rheumatoid arthritis
-Osteoarthritis
-Traumatic injuries of the thumb
When does hand dominance begin to
develop?
Hand dominance begins to develop at 3
to 6 years
and is not fully defined until 6 years
When does stiffness occur in
rheumatoid and
osteoarthritis?
-Rheumatoid: Morning stiffness lasts
longer than
one hour
-Osteo: Morning stiffness lasts less than
one hour
but stiffness returns after overuse at
end of day
When is a thumb spica used?
-Immobilizes the thumb while allowing other
digits freedom to move
-A long thumb spica splint also immobilizes the
wrist
-Immobilizes 1st CMC and sometimes 1st MP and
IP
-Hand based (short opponens splint)
When is the intrinsic plus splinting
position used?
-For individuals with burns and
traumatic hand
Injuries
When should continuous reinforcement
be
utilized?
When teaching new skills.
When should intermittant reinforcement
be
utilized?
When maintaining a behavior.
When should isometric exercises be
avoided?
-Cardiac patients
-Burns
-Rheumatoid arthritis
-Casts
When should sensory testing be
avoided?
-Receptive aphasia
-Atrophic (aptropy) skin
Which joint do you assess first? Always check uninvolved joint first to
establish a
baseline.
Which sensations return FIRST following
a nerve
injury?
Pain and temperature
Which side should a person with a
recent hip
replacement sleep on?
On the operated side to prevent
accidental crossing
of leg (adduction)
Who should you report client/patient
abuse to?
Immediate supervisor
You have a patient who is unable to step
off of a
curb or watch for cars. What Ranchos
level are
they at?
Level VI
STUDY SCHEDULE Werecommendstudyingforatleast6weekspriortoyourNBCOTtestingdate.Howeverthis
willvaryfrompersontoperson,somemayneed8-10weeks.
Agoodpracticeisspending2weeksonthestudymaterialandquestionsinthisguideandtakingnoteofanytopicsyoufeelweakin.Thenfilloutthe6weekcalendarandfocusyourstudytimeoneyourweakesttopics.Duringthis6weekswerecommendusinganyofthe
AOTA,NBCOT,orTherapyEdNBCOTExamprepcourses.
TodayisthebestdaytostartpreparingJ
For updates to this guide and more NBCOT Exam Prep material, visit: occupational-therapy-assistant.org/NBCOT
Fillinallyourdailyactivitiessoyouknowwhenyou’rebusyandcannotstudy(work,leisure,etc)
Nowwriteinalltheblocksoftimeyouwillstudy.Specifythetopic&activity.Ie:Splints,
flashcards,practicetest,reviewnotesetc.
Oncecompletelyfull,makesureyouscheduledtimetogoovereverytopicthatwillbetested.
Trytoscheduleafewgroupstudysessionsaswell.Usethistimetohaveotherstudentshelpyouwiththematerialyou’restruggling
with
exam survival kit
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8-9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
week 1
exam survival kit
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8-9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
week 2
exam survival kit
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8-9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
week 3
exam survival kit
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8-9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
week 4
exam survival kit
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8-9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
week 5
exam survival kit
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8-9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
week 6
NBCOT Exam FAQs
We’vecompiledthemostfrequentlyaskedquestionsregardingtheNBCOTExam.WeansweredtheadministrativequestionsandwethensurveyedCOTAs&OTRstogetanswersfromagroupofstudentswhopassedthe
examabouttheexamprepquestions.
For updates to this guide and more NBCOT Exam Prep material, visit: occupational-therapy-assistant.org/NBCOT
NBCOT Exam FAQs
Q: What is the cost of the exam?
A: The application fee is $500 online or $540 mailed in. There is also a $40 fee for score transfers plus a $45 confirmation fee.
Q: How long is the exam?
A: The time allotted is 4 hours
Q: What can/can’t I bring into the testing room?
A: You can bring: – Earplugs (not headphones) – Medical devices (insulin pump, hearing aid, etc)
You cannot bring: – Electronics – Paper notebooks or books – Head covering such as a hat or hood
Q: Where do I schedule my exam?
A: Submit an online application at nbcot.org or mail one in. Then send in your college transcript and fieldwork verification to NBCOT. You will then be issued an Authorization to Test (ATT) letter. At this point you may schedule your exam through Prometric at www.prometric.com choosing the closest testing center to your location.
Q: What happens if I fail?
A: Test takers must wait 45 days from the failed exam date before they may test again. There is a 15 day wait period after your last test before you may re-apply. You then restart the process of paying the fee and being issued an ATT letter. You may retake the test as many times as needed to pass.
Q: What are the pass rates for the NBCOT?
A: NBCOT OTR Exam = 78% / COTA Exam = 86%
Q: Will questions be asked one at a time?
A: Yes
Q: Are you able to mark questions and go back to them?
A: Yes, you can revisit questions and change your answers.
Q: After you answer a question, making your selection, are you able to go back and change your answer selection?
A: Yes, you can change your answers
Q: If you could give one piece of advice to a student preparing for the NBCOT, what would it be?
A: Read the question and all of the answer choices. You should usually be able to eliminate 2 of the 4 answers. Then reread the question and select from the remaining two answers.
Q: Describe your testing environment in detail.
A: Typical exam room with rows of computers set up in cubicles dividing them. You’re able to wear headphones to cancel outside noise. You’ll be in a room with folks taking a variety of exams such as the SAT and ACT. There are about 30 people in a test room.
Q: What items are students allowed to bring into the exam room?
A: Exam takers will be given blank paper and pen. You’re not allowed to bring water but you are allowed to take bathroom breaks (although they use up your test time). You will be given access to a locker for bags, purses, sweatshirts etc., it will be right outside the exam room.
Q: How many questions does the exam have?
A: The OTR exam has 170 Multiple Choice questions and 3 clinical simulation questions. The COTA exam has 200 multiple choice questions.
Q: Can I take breaks?
A: Yes but they take up your time limit.
Q: Can I make notes during the exam?
A: The testing center will provide pencil and paper or a marker and dry erase board for you to take notes
Q: How do I obtain my test score?
A: NBCOT scores exams twice monthly. Wait about 1-3 days after your exam and you will be able to check online to see if you passed or failed, just visit this webpage. 4-6 weeks after you test date you will be mailed an official score report. In order to have the score report sent to your state licensing board, you must fill out an Official Score Transfer Request during the application process or right after you take the test.
Q: Is there a list of books or study material used to create the exam?
A: The NBCOT maintains a list of the top 10 textbooks used to create both the OTR and COTA exams. They create an in depth report every so often that lists the textbook names and how much of the exam was created from them as well as which parts of the exam were created from each book. You can find the most recent updated reports for both the OTR and COTA exam here.
Q: Which mnemonics or charts were most helpful when studying for the NBCOT?
A: Charts and handouts on topics like Moro, STNR, ATNR, and Babinski were extremely helpful. Also, charts of common splints were extremely helpful. Try creating a page for each splint with an image and description of it that includes the splint name and use. Also make sure to review Ranchos, Glasgow, MMT, Brunnstrum, Coma Scale, and ROM norms/scales.
Q: Do you have any tips for the multiple choice questions?
A: Practice your clinical reasoning skills. You need to be able to read a treatment scenario and choose the best option. Most of the time two of the multiple choice answers will clearly be wrong and you can immediately eliminate them. Then you are down to just two options.
Q: Is there a tutorial to show you how to take the exam?
A: You can watch a tutorial before your exam time begins that will teach you how to proceed with the exam.
Q: Do you have any other advice at all that may be helpful to students preparing for the NBCOT?
A: The best advice is to take practice exams repeatedly. Take one early just to gauge where you are. Then go back and repeatedly take practice tests focusing on the study areas that you get wrong. Also, don’t forget to go over the basics, they are important and should be embedded in your memory to help with the many types of questions you will see. Make sure you know your norms, scales, common splints, reflexes, as well as diagnoses contraindications. Study alone, but also participate in study groups. Quiz each other and discuss why the right answer is right.
NBCOT Exam Tips
Wecompiledthebesttipswe’veheardfromOTRsandCOTAsinregardstopreparingfor,studyingfor,andpassingtheNBCOTexam.Everythingfromstudytipstodressingcomfortablefortheexamwillbecoveredhere.
For updates to this guide and more NBCOT Exam Prep material, visit: occupational-therapy-assistant.org/NBCOT
NBCOT Exam Tips
PICK YOUR RESOURCES
As soon as possible you want to start gathering your study resources for the NBCOT exam. There are tons of paid and free options for study materials and you don’t want to get bogged down with trying to study too many. Try a few of the free resources to get a feel for the study material and to see what is missing from them that you may need to purchase separately.
Once you have your resources chosen, you can lay out a schedule for exactly how you’re going to go about studying. Such as how much time you will dedicate to each topic and question type.
SCHEDULE YOUR EXAM (RIGHT AFTER GRADUATION)
Scheduling your exam is really important. It creates a deadline which will help you to buckle down on your study schedule and get prepared. Also, the sooner you schedule it after graduation the more momentum you will have going in. The material you’ve learned will be fresh and you won’t build up anxiety by waiting for a long period of time after graduation to sit for the exam.
CREATE A STUDY SCHEDULE (6 WEEKS MINIMUM)
As mentioned above, as soon as you have your study resources chosen, schedule the exam and create an attack plan for how you are going to consume all of the study resources you chose.
Everyone is different but we surveyed some OTRs and COTAs to see what they recommended for studying and everyone said at least 6-8 weeks of studying was necessary with at least 2 – 4 hours of studying per day. Of course these metrics will vary, but this should provide a good starting point.
TAKE PRACTICE TESTS
Good job, I know you are already working on this. Remember, you were freaking out about the NBCOT exam searching for NBCOT practice tests when you found this post.
Practice tests are an essential part of NBCOT exam prep as they provide insight into the test format, types of multiple choice questions, and example clinical simulation questions. After taking a few practice tests you will have developed a good pace for getting through the exam and you will have a good feel for the questioning which will increase your confidence.
ESSENTIAL TOPICS
We surveyed OTRs and COTAs to see what topics appeared most often on the NBCOT exam. We put together this short list of the most common testing topics that you should definitely be well versed on before taking the NBCOT:
• Glascow Coma Scale • Types of reflexes • Ranchos Los Amigos scale • Developmental milestones • SCI levels (specifically know which motor function is available at each sci level) • AOTA ethical standards (For example, you should be familiar with non-maleficence, beneficence, and social
justice etc.) • types of groups for mental health • Medical conditions (most of the conditions you see in the study guides will be on the exam)
NIGHT BEFORE EXAM
Believe it or not, the night before your NBCOT exam is not best spent cramming. At this point, you should try to relax and spend your time preparing for exam day. The night before should be spent getting everything ready that you’ll need the next day. Here is what you’ll need on test day:
• 2 forms of ID • ATT Letter • Print out of your appointment confirmation • Comfy outfit • Healthy breakfast (eat carbs and protein for the best and most sustained energy)
Although some review the night before can be helpful, don’t study too hard. At this point you really do know most of the information that you will be able to know before the exam. It is wise to spend some time reviewing what you know but studying new material or material you don’t know this late will not help you. You’re time will be better spent doing something relaxing to rest your mind and relieve some stress so that you sleep well (try to get 8hrs) and go into the exam fresh. Take a walk, run a bubble bath, watch re-runs of your favorite funny show, call your sibling… whatever your cup of tea is, make a cup.
EXAM DAY TIPS
The best advice for exam day is pretty simple. Keep in mind that the clinical simulation questions will come first and then you will take the multiple choice section. Here are some helpful tips for exam day.
• Dress comfortable • Eat a healthy breakfast • Don’t drink too much fluid before the exam (or you will waste time scanning in and out to go pee) • Save time by using the 10 minute break in between clinical simulation and multipl choice to use the restroom • Try spending about 1 minute on each multiple choice question, then you should have about 30 minutes to
review your answers